How likely is it for a mother to go into heavy labor on the way to the hospital and end up delivering on the front seat of a Toyota Prius? Not very. But it does happen.

In fact, it did happen Nov. 15 in Whitemarsh Township, near the Skippack Pike overpass of the Pennsylvania turnpike. The baby’s father pulled the car onto the shoulder and dialed 911. A Montgomery County Emergency Services dispatcher talked the father through the birth and a few minutes later, Ambler Community Ambulance arrived and mother and son were taken to Einstein Medical Center at Montgomery in East Norriton.

According to the Centers for Disease Control, about 39,000 American babies are born outside of hospitals each year. Eighty-three percent of those mothers planned on having an out-of-hospital birth. But what about the other 17 percent?

Dr. Elizabeth Zadzielski, Einstein Medical Center Montgomery’s Chief of Obstetrics and Gynecology, said these moms intended to deliver in a hospital, but their babies came too fast.

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Side-of-the-road births “(don’t) happen very often,” Dr. Zadsielski said. “I would say maybe every few months or so a mom will go into labor very rapidly at home and wind up delivering at home. So it doesn’t happen frequently, but when it does, it’s a concern.

“Typically it’s a mom who has had a couple of babies and it just kind of gets away from them, but sometimes, it’s not,” Dr. Zadzielski explained.

When pregnant women wait too long before heading to the hospital, she said, they become vulnerable to several risk factors that put both mother and baby in danger.

“Something that we always tell our patients, especially once they start getting strong and frequent contractions, is to call their doctors,” Dr. Zadzielski said. “And sometimes we’ll tell them to come into the hospital.”

Dr. Zadzielski stressed that patients should not feel “self-conscious” or hesitant about going to the hospital during the final weeks of pregnancy — even if their perceived labor signs do turn out to be a false alarm.

“You don’t want to be in the situation where your worst case scenario is the baby gets stuck, meaning that the baby can’t come out by itself, something called dystocia can happen,” she said.

“Once the baby is born, sometimes the mom can breathe very heavily or hemorrhage, and if that happens at home, it can be life threatening for them.”

“If (the baby) passed stool while inside (the womb) they can very easily aspirate that into the lungs and it can be very dangerous as well,” Dr. Zadzielski said, referring to meconium aspiration, another complication that could make an unplanned, out-of-hospital birth especially dangerous.

Of course hospitals use sterile equipment, Dr. Zadzielski added, so a birth that is not overseen by an “appropriate provider” can be problematic even if complications don’t arise.

“For a mom who delivers at home, there is a greater risk of an infection and things of that sort,” she said, adding that “newborns need to be dried off and kept warm, and sometimes they do need a little help at birth.”

While some pregnant women may be concerned about the possibility of going into a fast labor before making it to the hospital, Dr. Zadzielski said they should not be alarmed.

“I don’t want to frighten patients, especially first-time parents,” she said, “and I also don’t want to encourage even the notion of being able to give birth at home without a proper attendant. We’ll often tell patients if things change too quickly for them, to call 911.”

Parents should work with their health care provider to learn the signs of early labor. Many childbirth education classes cover emergency birth procedures. Classes on infant and child life support are offered by the American Red Cross and the American Heart Association.

“Especially in the last several weeks of pregnancy, we always go over the signs of labor for all moms, and always encourage them that they should call us or just come to the hospital if there’s any question in their mind,” Dr. Zadzielski said. “I’d always rather send someone home one or two times than take the chance of someone delivering on the turnpike or at home.

“I came back and forth a couple of times myself with my first child, but you know, it happens,” Dr. Zadzielski said with a laugh. “And everyone understands that. I always tell patients they really shouldn’t feel self-conscious about it. I tell them that’s what we’re here for. They have to let us do our jobs.”

Einstein Medical Center at Montgomery welcomed its first baby on Sept. 29, just nine hours after doors opened. Since then, the new hospital has exceeded projections, Dr. Zadzielski said.

“We were projecting 80 to 85 births per month when we first moved in here, and we did 120 births in October and we’re now at 110 for November (as of Nov. 27), so we’re exceeding all of our expectations and absolutely enjoying being able to deliver the type of care that women in this community had needed. It has been very gratifying. It’s working out nicely.”

If a mother goes into labor, and she’s far from the hospital she planned to give birth, she should get to the nearest hospital, Dr. Zadzielski said. “Doctors in emergency rooms are able to deliver babies even if the hospital does not have an obstetric unit. Rather than driving around on the Schuylkill trying to find a hospital that does deliver babies, just get to the nearest hospital. If you haven’t had the baby by the time you get to the emergency room, you’ll be assessed by the emergency room doctor and if it’s safe, you can be transported by ambulance to a hospital that does deliver babies.”

Emergency personnel are trained to talk parents through a delivery, Dr. Zadzielski said, recalling a story from more than 20 years ago. “I had to help with a birth over the phone because the baby was delivering in the field, and I was talking the paramedics through it.

“It does happen, and they are equipped to be able to do it,” she said. “The baby was coming breached and … they called ahead to the hospital, the old Newcomb Hospital (in Vineland, N.J.). I was the doctor on call, and I talked him through maneuvers needed for a breached delivery. Mom and baby arrived at the hospital just fine. The paramedic looked a little shaken, but he was OK after a while.”